LeadUS Mentoring Program 2015-16

Welcome to Lead 101 Mentoring, Inc. - Mentoring Program 2024-25 Application! We are very glad to know you are interested in participating in our program and achieving all of your dreams. Please carefully read this application. Make sure the information you provide is complete and accurate. Also, please do not leave any blank space. You will need to submit this form completely until August 2nd, 2024 at 11:59pm. If you have any question/issue, do not hesitate to reach us at admin@lead101mentoring.org.

We look forward to growing with you + your son(s) this year!
Tell us who you are*
How did you hear about Lead 101 Mentoring, Inc.?

Teen's Personal Information
Full Name*

First NameMiddle NameLast NameSuffix
Birth Date*

DayMonthYear
Mobile Number*

Area CodePhone Number
E-mail*
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Education
School name*
School type*
24-25 Current Grade
Graduation date (estimate)*

DayMonthYear
Are you participating in any other mentoring program? If yes, which one?
Most recent grade point average (GPA)
English Proficiency
Any Behavior or Learning Challenges? (Confidential information for Mr. Porter to apply any needed accommodations.)
Have you ever taken the ACT test before?
If yes, what is your test Score
Do you currently have a job? Are will you have one during the 24-25 school year?

Parent Information
This section is for our leader, KP, to better understand you and your teens' lifestyle.
Parents are:

MarriedDivorcedNever married
Mother's Name
Age
Profession
Father's Name
Age
Profession
How many people live in your house including you?
Are there any siblings in this household? Please list their ages

Parent Short questions
In the short questions, we ask you to briefly talk about your main idea and points, being concise and direct as well as explanatory.
In no more than 150 words explain why you want your son to participate in the Lead Program*

0/250
Why do you believe that participating in a mentoring program would help them achieve their future goals?*

0/100

Teen Statements
Statements are the opportunity for you to differ yourself from others and shine. Be direct, descriptive, and creative. This is your time!

You are about to write two essays: one Personal Statement, which the prompt is the same for all applicants. In addition, you will also need to work on a Writing Supplement, which you will be able to choose from the five options listed below.

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Your Personal Statement is very important for us to better understand who you are. Please write your Personal Statement in no less than 250 words and more than 650 words and based on the prompt below:

Personal Statement Prompt: Describe the world you came from and how that shaped who you are.
Personal Statement*

0/650
Your second essay is your Writing Supplement. Now, you have the opportunity to detail more about yourself. You will be able to pick one out of the four (4) essay prompts below. You will need to write your essay in no less than 250 words and no more than 650 words.

Be amazing. Be creative. Be yourself!
Writing Supplement Prompts: choose the one you are writing about.*

What are you passionate about?Describe an experience where you were unsuccessful in achieving your goal. What lessons did you learn from this experience?What movie, poem, song/rap, or book has most influenced your life and the way that you view the world?Imagine looking through a window at any environment that is particularly significant to you. Reflect on the scene, paying close attention to the relation between what you are seeing and why it is meaningful to you.
Writing Essay*

0/650

Submission
Is there any other information that you would like to share with us?
Did you have any problem while filling out this form? If so, please report it below
Do you agree to submit to us your personal, familiar, and educational information and are aware that we will not use those informations instead of and only for Lead 101 Program's purposes? You confirm to be submitting only truth information, otherwise your Application might be canceled and you will not be able to be admitted for the Lead 101 Program Mentoring 2024-25*

Yes, I agree / Understand
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